Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria

Potentially inappropriate prescribing in a falls clinic using the STOPP and START criteria

Background Potentially inappropriate prescribing is increasingly common in older patients with falls. However, published indicators to assess inappropriate prescribing remains unestablished in many countries. Objective This study determined the burden and profile of potentially inappropriate prescri...

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Bibliographic Details
Published in:International journal of clinical pharmacy Vol. 44; no. 1; pp. 163 - 171
Main Authors: Chiam, Rosalind, Saedon, Nor’izzati, Khor, Hui Min, A/P. Subramaniam, Sukanya, binti Mohmad Nasir, Siti Sakinah, binti Abu Hashim, Noor Fatin Izzati, Tan, Maw Pin
Format: Journal Article
Language:English
Published: Cham Springer International Publishing 01-02-2022
Subjects:
Accidental Falls - prevention & control
Aged
Aged, 80 and over
Ambulatory Care Facilities
Female
Humans
Inappropriate Prescribing - prevention & control
Internal Medicine
Male
Medicine
Medicine & Public Health
Pharmacy
Polypharmacy
Potentially Inappropriate Medication List
Research Article
Aged
Adverse drug events
Accidental falls
Inappropriate prescribing
STOPP START criteria
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Summary:Background Potentially inappropriate prescribing is increasingly common in older patients with falls. However, published indicators to assess inappropriate prescribing remains unestablished in many countries. Objective This study determined the burden and profile of potentially inappropriate prescribing among patients attending a falls clinic using the STOPP/START criteria and evaluated the factors for falls potentially associated to inappropriate prescribing. Setting University of Malaya Medical Centre Falls Clinic. Method Data of individuals aged ≥ 65 years referred to the falls and syncope clinic were extracted from the falls registry. Potentially inappropriate prescribing was determined with the STOPP/START version 2 criteria. The relationship between potentially inappropriate prescribing with polypharmacy (≥ 5 medications), comorbidities and clinical variables were determined using Pearson’s chi-square and potential confounders adjusted for with multivariate regression. Main outcome measure Potentially inappropriate medicines and/or omitted medicines using STOPP/START criteria. Results Data from 421 individuals, aged 77.8 ± 6.7 years and 53.4% women, were included. Potentially inappropriate prescribing was present in 311 (73.9%). Potentially inappropriate medicines use accounted for 84.6% of the 325 prescriptions. 361/659 instances (54.8%) were falls-risk-increasing drugs, with vasodilators (49.3%) being the main potentially inappropriate medicine identified. Of the 177/421 with polypharmacy, 169/177 (95.5%) were exposed to ≥ one potentially inappropriate medicine. 129 instances of potentially omitted medicines were observed in 109 prescriptions (25.9%). Conclusion STOPP/START criteria are useful to identify potentially inappropriate prescribing at the falls and syncope clinic. This finding has important implications for medication review strategies at falls clinic. Future research should determine whether identifying potentially inappropriate prescribing may reduce adverse falls outcomes among patients in this setting.
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ISSN:2210-7703
2210-7711
DOI:10.1007/s11096-021-01329-9